The Doctors Blackwell

by The Doctors Blackwell (retail) (epub)

  A generation older than the Blackwell sisters, Dix had built an international reputation on advocacy for the insane, working for asylum reform on both sides of the Atlantic as a lobbyist, not a medical practitioner. She was a passionate admirer of Florence Nightingale and her work with the British Sanitary Commission. When the war began, Dix made a beeline for Washington and was soon overwhelmed with inquiries from women eager to volunteer. She was a logical liaison for the Women’s Central: nurses trained in New York could be sent to her for deployment.

  Touring military camps and hospitals at Dix’s side, Bellows and his colleagues began to envision a Washington-based entity that could not only oversee women’s relief efforts but also advise the military on sanitary issues. In mid-May they submitted a proposal to Simon Cameron, the secretary of war, outlining their ideas for a commission of philanthropists, military experts, and physicians to receive the goodwill of the people and direct it toward the health and comfort of the soldiers, as dictated by the latest scientific information. In England, this kind of effort had followed only after the Crimean War, its purpose to analyze past mistakes and recommend improvements. In forward-thinking America, Bellows’s proposal insisted, such measures must be taken immediately. The proposal was swiftly approved, and in June 1861 the United States Sanitary Commission was born, with Bellows as its president in Washington and the Women’s Central as its auxiliary in New York.

  The informal April meeting at the Blackwells’ infirmary had led directly to the creation of the most important civilian organization of the Civil War. But as Bellows and Dix rose in prominence, the Blackwells retreated in frustration. “We shall do much good, but you will probably not see our names,” Elizabeth wrote to Barbara Bodichon, “for we soon found that jealousies were too intense for us to assume our true place.” The Sanitary Commission was happy to enlist the efforts of females and physicians, but not of female physicians.

  The Blackwells’ infirmary was pointedly excluded from the list of New York hospitals approved to train nurses, those hospitals having made it clear that they would refuse “to have anything to do with the nurse education plan if ‘the Miss Blackwells were going to engineer the matter,’ ” Elizabeth quoted with disgust. These were the same hospitals that continued to prohibit female medical students on their wards—they were not about to partner with female physicians now. And it wasn’t just the male medical establishment that objected; several lady managers of the Women’s Central, Emily noted, expressed concern “lest our name should make the work unpopular.” With casualty figures growing daily, it was unpatriotic for the Blackwells to argue. “Of course as it is essential to open the hospitals to nurses, we kept in the background,” Elizabeth wrote in resignation. “Had there been any power to support us, we would have fought for our true place, but there was none.”

  To compound the insult, the most prominent role in the nursing effort—Matron General and Superintendent of Women Nurses—had gone to Dorothea Dix. “Miss Dix, though in many respects an estimable & sensible woman, is deficient in the power of organization, and has no idea of the details of Hospital management & the requisitions for this peculiar service,” Emily wrote. “I think there cannot fail to be much confusion.” Elizabeth was less restrained. “The government has given Miss Dix a semi official recognition as meddler general,” she spat. “A showy false thing has more success than an unpretending truth and it is very difficult to make truth pretentious, it does not puff up nearly as readily as falsehood.” Emily might have been accustomed to following another woman’s lead, but Elizabeth was incensed by Dix’s appointment, especially when her own medical qualifications were so much stronger.

  Elizabeth and Emily continued to work long hours for the Women’s Central during the first year of the war. But a year was as much as they were willing to give. In June 1862, Elizabeth told her brother George, “We completed the 100 nurses that we have sent on to the war—wrote up the annual report, made up the treasurers accounts, and then resigned our place in the Registration Committee.” Not only had their male colleagues left them behind as the Sanitary Commission in Washington grew, but the ladies of the Women’s Central Association for Relief had disappointed them as well. “They were inclined as summer came on to do as they did last year,” Emily wrote in exasperation, “all go out of town and leave the whole work of the Committee on our shoulders.” Wartime philanthropy was no match for the swampy heat of a New York summer, at least for those wealthy enough to escape it.

  Elizabeth and Emily had diverted enough energy from their own work, especially given the implacable chauvinism with which their tireless efforts had been received. From this point, they let the war go on without them. Intermittent and incomplete engagement was not unusual on the Union home front. Sam, Henry, and George, now in their thirties and a decade older than the average Union soldier, stayed home; Henry was among those who opted for “commutation,” the practice of paying cash—about $300—to avoid military service. Older men with wives, children, and professional responsibilities tended to see enlistment bounties as a form of patriotic contribution. “I have given up reading the newspapers and following politics, for it all seems such an unsatisfactory muddle,” Emily confessed to George. “I see no issue and as I can’t do anything I don’t allow myself to be so absorbed in public affairs as people are generally.”

  The sisters turned their attention to the project of building a small cottage on a wooded ridge in Bloomfield, New Jersey, using the money Madame de Noailles had earmarked for a sanatorium. The retreat would provide therapeutic fresh air and greenery for the infirmary’s patients, and much-needed relief for their exhausted doctors. The house was still under construction in January 1863, when President Lincoln issued the Emancipation Proclamation—followed in March by a national draft to replenish the Union forces. “Our carpenter & mason will put no heart in their work till drafting day is over, they are so afraid of it,” Emily wrote.

  In New York City, white working-class resentment—sparked both by the draft and by the fear that emancipated Black workers would soon flood the labor market—resulted in several days of lethal violence in 1863, known to history as the Draft Riots but quickly devolving into white-on-Black terrorism. Kitty and Elizabeth were in New Jersey when they heard news of the violence, and immediately headed for the city: Elizabeth to protect her patients, and Kitty to protect Elizabeth. Leaving the ferry at Cortlandt Street and unable to find a carriage, they walked the two miles to the infirmary in the July heat, warily skirting a muttering mob on Broadway.

  At the infirmary, they found the patients in a state of panic, clamoring to turn out the single Black woman on the ward lest she draw the attention of the rioters. As Kitty remembered it, the white patients were tersely informed that they were free to leave; the Black patient would be staying. No one left.*

  Once the Bloomfield house was ready, Elizabeth spent every weekend there, gazing over the hills and picking out the ships in New York harbor with her telescope. “The green flickering light, the rustling leaves, and moss & flowers, charm all my senses,” she wrote. “If I am anxious they soothe me, if sad they cheer, if worried they calm.” Though she brought ailing patients along to recuperate, the cottage’s salutary properties were most enjoyed by Elizabeth herself. (Despite Emily’s love of the natural world, there is less evidence that she spent much time there. For her, its most salutary property might have been that it provided a break from Elizabeth’s company.) “You will wonder at my hopes & plans, while the country is in such a state,” Elizabeth acknowledged to Barbara. “But strange to say, business never seemed more flourishing, and every sort of undertaking seems to go on as usual. I think [this] a hopeless war, which I trust Providence will bring good ends out of—I cannot approve of either side—so I work on.”

  Three years into the war, Elizabeth at last traveled to Washington herself—as a tourist. Though her train rolled through “villages of tents & shanties & baggage waggons” on the outskirts of the capital, she described what s
he saw with a blithe cheer that belied the bloodshed just a hundred miles to the south; more than ten thousand Union soldiers were dying at the Battle of Cold Harbor, and no one could yet know that this Confederate victory would be General Lee’s last. “We have had charming weather,” Elizabeth wrote gaily to Kitty. “I am certainly seeing Washington under the best possible auspices.” Her upbeat observations were likely intended to spare her ward’s tender teenaged sensibilities, but they may also have reflected her own detachment from the conflict.

  Escorted by her old Philadelphia friend William Elder, who now held a position in the Treasury Department, Elizabeth took in government buildings and monuments, the city’s avenues and squares, the wonders of the Library of Congress, and the lavish fare at her hotel, from mock turtle soup to strawberries and cream. She paid a call on Dorothea Dix, “making acquaintance with the lady, and watching her style of working.” But Dix was hardly the most notable of her encounters.

  Dr. Elder had brought Elizabeth to see the public reception room at the President’s House, and she was admiring the view of the Potomac from its windows when Judge William Darrah Kelley, a congressman from Philadelphia and close friend of Lincoln’s, happened upon them. “Why don’t you go up and see the President?” he asked them. “He is all alone, it is a good chance for you.” The visitors were startled, but as Elizabeth told Kitty, “Dr. Elder & I are always ready for any deed of daring.” Shepherding them upstairs, Kelley “swept aside the usher & opened the door of a large comfortable square room on the second floor.”

  Elizabeth was surprised at the sight of the “tall ungainly loose jointed man” who stood before her. “I should not have recognized him at all from the photographs—he is much uglier than any I have seen,” she wrote. “His brain must be much better in quality than quantity, for his head is small for the great lank body, and the forehead very retreating.” Phrenologically speaking, Lincoln was underwhelming—an impression that was reinforced when he perched himself on a corner of his worktable and “caught up one knee, looking for all the world like a Kentucky loafer on some old tavern steps.” It was hard to credit this gangling character as the brilliant writer and thinker she knew him to be.

  A more gregarious or aggressive woman—Marie Zakrzewska, say—might have seized this rare opportunity to engage the president of the United States on health policy and the future of women in medicine. But Elizabeth’s disappointment in the Sanitary Commission was still fresh, and face-to-face confrontation had never been her style. After a brief exchange of pleasantries with the president, she excused herself. “Altogether it was a most characteristic little peep, immeasurably better than any parade glimpse,” she wrote, “so I considered myself quite in luck.” In her memoir, the chronicle of her own campaign, she neglected to mention the meeting at all.

  Elizabeth’s account of her visit to Washington did not edit out the war entirely, but even when confronting the brutal reality—some of the wounded were quartered at her hotel—she sounded more like a sightseer. She was disappointed in the Department of the Navy—no model warships or rebel flags to see—but perked up at an invitation from a young army doctor to tour the four-hundred-bed Douglas Hospital, a few blocks from the Capitol. In one ward full of wounded men, she paused by the bed of a “handsome dark eyed young man” who, with his elderly father by his side, seemed “comfortable though weak”—a peacefully poignant tableau that was unfortunately ruined by a sudden “torrent of red blood pouring from a hole in the middle of his thigh.”

  Elizabeth soon took her leave, with “a very cordial greeting from the excellent young Doctor,” who gave her a souvenir photograph of the hospital. She had always been more interested in institutions than in individuals. And though the national crisis was not yet over, she and Emily had a new institution in mind.

  * In her old age, Kitty dictated her memories to various family members. An earlier version of this story is slightly different: upon reaching the infirmary, Elizabeth and Kitty found the wards empty except for the Black woman. When the staff refused to turn her out, the white patients had fled. In both versions the infirmary staff is honorably protective of the woman in peril. In the earlier one, they are unable to influence their racist patients, who leave en masse; in the revision, their principled stance inspires their patients to swallow their prejudice and stay. Elizabeth pledged her life to raising humanity to a nobler plane, and Kitty was her most devoted acolyte. It seems in keeping that Kitty might have revised her memory to show the Blackwell example in the noblest and most successful light.

  CHAPTER 16

  COLLEGE

  The last thing the Blackwells had intended was to found a women’s medical college. Their goal had always been to open existing colleges and hospitals to women, not to segregate women in separate, second-class institutions. They had watched in irritation as the female medical colleges in Philadelphia and Boston grew and prospered, attracting patrons and publicity with apparent ease. “They have each quite a large number of superficial people engaged in pushing what each year I think a sillier & sillier scheme,” Elizabeth complained to Barbara Bodichon. “The products are as worthless as you can well imagine & I have yet to see the first decent doctor come from either of those schools.”

  The Blackwells had founded their New York Infirmary as a place for newly fledged female M.D.s to train, but the graduates who joined them over the next decade were less than impressive. Young women had weaker educational backgrounds than their male counterparts, and at the women’s medical colleges they studied with professors who were often mediocre—by definition, or else why would they be teaching at a women’s medical college? “I am sick of the farce of bestowing degrees upon these half educated school girls,” Emily wrote. The Blackwells’ disdain might be legitimate—they had worked harder in pursuit of their own credentials—but it confused their allies when these two pioneers of women’s medical education heaped scorn on women’s medical colleges. “It is the old difference between me & the woman’s rights party,” Elizabeth wrote, “too conservative for the reformers, too progressive for the conservatives.”

  Compounding the problem was the old-world formality Elizabeth and Emily projected. New Yorkers might hold up the Blackwells as examples, but they didn’t particularly enjoy their chilly company. It was much easier to embrace women like Ann Preston, alumna and soon to be dean of the Female Medical College of Pennsylvania, a woman whose “sentimental air of martyrdom” the Blackwells abhorred. Preston had received a warm (and lucrative) reception when she came to lecture on physiology and hygiene at the invitation of the New York Infirmary’s trustees; when asked why they had overlooked the infirmary’s own founding physicians, these ladies protested, “Oh we couldn’t go to [the Drs.] Blackwell as we do to Ann Preston—we are almost afraid of them.” Unwilling to unbend, Elizabeth and Emily struggled to connect with the very women they inspired. “Somehow they always seemed to feel that it was not their place to come & help us,” Emily wrote, “but to stand by & see what we were doing.”

  The situation came to a head with the establishment of a third women’s medical college, this time in New York City itself, not far from the infirmary. Its founder, Clemence Sophia Lozier, had received her degree from the Central Medical College in Syracuse, one of the Eclectic schools that Elizabeth and Emily dismissed. “If we could have joined with these persons we should have done so,” Elizabeth insisted, “but we found their ideas of medical education so low, their hostility to the profession so rooted, and their distrust of us, so marked, that it was impossible to join forces. . . . The whole thing is a repetition of the Boston and Philadelphia attempts on a still poorer scale.”

  Incorporated in April 1863, Lozier’s New York Medical College for Women trumpeted its own founding in a way the Blackwells found galling. “Being the first in this city,” its annual report proclaimed, “it may be regarded as an index of advancing civilization, as well as in its character marking the progressive era in medical science.” All of its trustees were w
omen, and Lozier announced her intention to strive eventually for a faculty that was likewise entirely female. Elizabeth thought this was ridiculous. How could an aspiring woman doctor hope to succeed if her professors were themselves relatively inexperienced women? “The true plan is for women to use men for their own objects,” she wrote, “not exclusively of course, but just as far as they can better accomplish their object by so doing.” She dismissed Lozier’s students as “a vulgar little class of women, led by one of the commonest type of woman’s rights women.”

  So: the superior medical education available to men was—despite Elizabeth and Emily’s successful examples—still off-limits, and the institutions that did offer medical education to women were, at least in the Blackwells’ opinion, woefully inferior. How should they proceed? By changing their minds, though not their standards.

  “We believe that the time has come to form a really good school of medicine for women,” Elizabeth announced to a meeting at the infirmary. It was a week before Christmas 1863; Abraham Lincoln had delivered his address at Gettysburg a month earlier. Though the war dragged on, the Blackwells drafted a speech that both summed up their criticisms of the state of women’s medical education and pointed a way forward. The “blank wall of social and professional antagonism” faced by aspiring women doctors may have begun to crumble, but they still suffered from a disabling lack of access: not just to schools and hospitals but also to prizes, professorships, medical societies, and the stimulating companionship of colleagues. And then there were the more fundamental handicaps. “Women have no business habits,” the address declared, “girls are seldom drilled thoroughly in anything; they are not trained to use their minds any more than their muscles; they seldom apply themselves with a will and a grip to master any subject.” Combine this lack of discipline with the pecuniary instability that propelled most women toward a profession in the first place, and it became clear that what women needed was, if anything, a medical education superior to that available from any existing medical school, male or female.